Deadly Fakes Around the World

The widespread of counterfeit medicines is inherently a dangerous problem. However, its distribution is not even in different parts of the world. Despite World Health Organization’s (WHO) effort to defeat counterfeiting in one stride, different measures are needed for each region. The loose punishment scheme in many countries and the strictness on others, the different strategies, transportation and distribution methods used and the variety of medicines being falsified are considered as hindering factors for full implementation of security measures. Although rich nations have fewer breakdowns on the issue, they are not exempted from the threat.

A plethora of evidences, methods and types were covered by WHO and have shared to other institutions campaigning on the same cause. One of them is The Peterson Group, a non-profit organization which has been advocating against the proliferation of counterfeit medicine since 2005. On its ten years, the group, which has formed members across South East Asia, Australia, the United States and United Kingdom, has gathered reports from different developing cities and nations. The following is the summary of each region’s brief background on counterfeiting medicines:

North America

Counterfeit medication is a recognized and well documented problem in the United States. One case in 1937 has featured more than a hundred deaths after consuming medicines containing the dangerous solvent diethylene glycol.

Some counterfeiters in the United States are even found to be using fraudulent connections to terrorism. WHO has also found that the profit from counterfeit medicines have been used to fund the famous terrorist group Hezbollah.

Europe

There are few fake and substandard drugs in most European countries for reasons similar to those articulated above for the United Sates: quality producers dominate the market, supply chains are generally well regulated, and officials provide strong oversight and strict enforcement when pharmaceutical standards are violated. Still, preventing fakes from entering or travelling through the two dozen European territories is a constant challenge for enforcement officials.

Cambodia

Cambodian Ministry of Health has released a statement stating that 13% of the nation’s medicines are fraudulent. Warnings on health precautions are already released by local government units and private pharmaceutical companies as most counterfeit medicines are found in informal and unlicensed units.

Indonesia

Counterfeiting in Indonesia has grown despite the warnings of death penalty as punishment. By 2008, 44% of medicines in the market are counterfeited, even sold in legitimate pharmacies. 11 men were arrested in the capital city, Jakarta for refilling syringes with water, forging expiration dates and repackaging. 

Precautions and Warnings on Counterfeiting

Asia is famous to nearly all kinds of forgery and fraudulence. China leads the rest of the continent in bearing the name ‘fake’. Perhaps these accusations have their bearing. After all, the products which are counterfeited would trace back to illegal production companies in the region. Dirty politics and lax of security has had a lot to do with it, as so many bad reviews had pointed out.

Nevertheless, Asia, with more developing countries than developed ones, has had a lot of records in combating the issue at hand. The Peterson Group, a non-profit organization campaigning against the proliferation of counterfeiting medicines notes that changes have been developing and plans have been integrated to prevent this issue from spreading. In fact, World Health Organization has summarized more legislations and suggestions on counterfeit combating as advised by many Asian members in the congress.

The following are possible measures in contending the problem:

•              National Government

The government, perhaps, has the most important role in stopping counterfeiting. With a stable policy and regulation, proper execution of security, there would be a good chance penalty can be imposed on fraudsters. Those in office have the power to enact rules and legislations which can help strengthen the campaign against spurious, falsely-labeled, falsified and counterfeit medicines. They can foster cooperation between different sectors of the government that play a role in the process. Medicine legislation should be formed and they should be the ones to ensure that counterfeit meds are confiscated and destroyed. United Kingdom has started their own government campaign but many critics say that developing cities who are also taking their own stand like Jakarta, Indonesia and Singapore have too much politics to implement proper policies.

•              Consumers

Consumers also have their share of responsibilities. We cannot always complain and do nothing. We, as the people who would be directly affected by the effects of counterfeit medicines should be suspicious and cautious of our every purchase. As much as possible, do not buy from a peddler or in market places, do not trust large discounts and check if labels or packaging would hint distrustful information about them. Also, be aware of emergency numbers to dial in case you may encounter one.

•              Medical Organizations and Pharmaceutical Companies

Since there are issue and conflicts occurring between the government and private companies when it comes to disclosure of information, there would always be miscommunication. These companies should work closely with national law enforcement and not entirely conceal their own information to themselves.

WHO Warning Falls to Deaf Ears

It would have been better if World Health Organization has cautioned the blind and the deaf, they may have listened more but the ignorance of people to precautions and warnings has led to high mortality rate and worsening disease symptoms.

Using different media and even fellow non-profit organizations, WHO has rounded up most information both in developing and already developed countries? From the busy streets of New York to the heavy traffic in Jakarta, Indonesia, the information has been passed on. The organization also took advantage of the partnership with other institutions. The Peterson Group, an online non-profit society is one of the institutions avidly campaigning against the proliferation of counterfeit medicines in South East Asia. Along with numerous local groups campaigning for the same cause, a lot of developing Asian nations are already informed. Yet, there may be possible reasons for people to become unaware.

The variety of information makes compiling data a difficult task. Sources of information include historic data which can sometimes already be obsolete. This is one of the reasons why there is not much trust in the information given by WHO and the main details are oftentimes overlooked.

Another factor hindering information from being spread are the political powers moving behind their names and standing in society. Those who have the authority to inform may not have fully discussed the severity of the situation and may have not emphasized the impact of counterfeit medicines to one’s health. It may also be that the authority itself is behind fraudulent transactions, gaining profits from mafia groups and scammers.

Strengthening medicine regulatory authorities (MRAs), improving quality of production, and facilitating the availability of relatively inexpensive, good-quality anti-infective are likely to be key factors in the effectiveness of the information being responded to.

There is an urgent need for data of sufficient sample size with random sampling design to reliably estimate the prevalence of counterfeited medicines. Such data are vital to select appropriate interventions, assess their effectiveness, and follow changes through time. Recent literature has concentrated on poor-quality anti-malaria, but it is likely that other anti-infective medicines are also profoundly affected. We do not know how counterfeit and substandard medicines compare with respect to their impact. We also have little information on what proportion of patients or health workers are aware of the issues in different societies, and which interventions may be the most effective. Without the help of different sectors, these planned interventions may not come to realization.

Medicines, an Intellectual Property

Counterfeit, substandard and fake medicines pose a great risk. Counterfeited clothes, bags and accessories have economic effects, loss of profits and perhaps cause financial downfall. Employment and income which is supposed to be directed to the legitimate brand are being distributed to counterfeiters and imitations. However, the concern of brand owners are being disputed since counterfeited items are helping these brands market their name.

Counterfeit Medicines do not rock the same boat. Not only would the manufacturers lose economically. Fraudulence in this field also poses a great risk in health. The World Health Organization (WHO) which plays the main fortress of many organizations and causes against the widespread of counterfeiting medicines has highlighted the issue by decreeing different kinds of trump cards and bylaws. In the passing of time, while the panic withers away, fraudsters have also strengthened their strategies. They got fiercer, not even considering trademark issues and deceitfully duplicated brand after brand. Unlike the spreading market for clothes’ brands, counterfeited labels bring trust down and cause reputation to plummet.

According to reviews archived by The Peterson Group, a non-profit organization campaigning against the proliferation of counterfeit medicines, in 2003, the biggest conflict faced by authorities regarding protection of intellectual property rights is the agreement of the World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRIPS) who both offers vague rules and statements against trademark infringement in medicines being exchanged internationally. A 2003 agreement loosened the domestic market requirement, and allows developing countries to export to other countries where there is a national health problem as long as drugs exported are not part of a commercial or industrial policy. Drugs exported under such a regime may be packaged or colored differently in order to prevent them from prejudicing markets in the developed world.

Many critics stated that there should be a clear line for differentiating normal cases of trademark infringement to counterfeiting which penalties for offenders apply. It is for the trademark owner to initiate infringement proceedings. However, for a number of reasons, developed countries, including Germany, USA and UK are opposed to extending criminal sanctions for infringement.

Developing cities have also participated in the agreement between WTO and TRIPS but they are given longer time for proper implementation. Surprisingly though, they have faired better in the adaption of sanctions. Jakarta, Indonesia and Bangkok, Thailand are both emphasizing their complaints against intellectual property rights as they have local medicine manufacturers in their stead.

However, it is a different issue for less developed countries. It has been argued that TRIPS implementation is far detrimental to these countries’ development. The flexibilities may not be drafted because of the lack of legal and technical expertise. It is yet to be determined when the extension of the transition to TRIP method happens on January 2016.

PROBLEMS AND SOLUTIONS TO COUNTERFEITING

Warnings on the global boom of counterfeit medicines have been known to bring forth realization of the unwanted and dangerous business. Moreover, those who are often victimized are from developing nations but global awareness has been expected to reach even the most illiterate parts of regions through advanced technology. It is now a race on who would reach the market first: the warnings or the advancing fraudulent methods used by scammers.

According to The Peterson Group, a non-profit organization advocate in eliminating the production and distribution of counterfeit drugs, 80% of counterfeit medicines proportion has been dominating in some wholesale pharmaceutical companies in Africa. 

China still remains to be the largest distributor of counterfeit medicines, operating in almost 500 factories around the country. The number has been expected to increase over time. Far from what is also expected to developing nations, these counterfeited medicines still cause adverse effect and reactions and can still cause deaths despite advanced methodologies being practiced? 

In South East Asia, the weak implementation of law is still a prevailing issue. Despite the efforts of Jakarta, Indonesia and Singapore to stop illegal smuggling of counterfeit medicines by putting warning signs at airports and implementing death penalty on anyone who breaks the law, transactions within these regions are still predominating. It makes it easier for smugglers in Indonesia since there is more than one entrance for inter-island transactions. 

In order to contain global scourge, the more advanced countries should assist less developed ones. Dynamics of these developing sources should be integrated with that of properly implemented nations. This problem cannot be eliminated if the supply-demand issues continue to hinder non-profit organizations, the government and the public to fully enforce proper solutions. 

Since there are more than concerns which should be done, International Policy Network of London has listed some possible solutions for this prevailing issue which causes thousands of deaths annually:

• Adjudication of disputes over contracts should be simpler and cheaper, so that contracts may be more readily enforced.

• Bureaucratic restrictions on doing business should be removed.

• The manufacturers of brand goods should be able more effectively to protect their trademarks.

• Most fundamentally, courts of law should be granted greater independence, so that their rulings are more impartial and less influenced by powerful vested interests.

• The legislature should not have the power to interfere with judicial decisions.

• The power of law enforcement agents should be curtailed and their actions subject to judicial review.

• The actions of other government agents (e.g. regulators) should be subject to judicial review.

• Regulation restricting the supply of medicines should be improved or scrapped. 

• Governments should reduce taxes and tariffs on all medicines. 

Common Ingredients of a Counterfeit Medicine

Counterfeit Medicines are rampant in many developing countries around the world.  The advancement of technology has also been taken advantage of by many fraudsters and scammers operating under illegal authorization and against the law. In as much as using technology being advanced, the ingredients that are being used in producing these counterfeit medicines are cheaper and what Food and Drug Administration (FDA) has been warning about.

The Peterson Group, a non-profit organization campaigning against any use of counterfeit medicines in any forms of production, manufacture, importation, exportation and distribution features the known chemicals and substances included in most illegal drugs’ ingredients.

1.            Heavy Metals

a.            Mercury

Test results from a 2010 study shows 26% of sampling medicines purchased from fake online pharmacies contains heavy metal and toxins including mercury. An intake of this element can cause peripheral neuropathy, skin discoloration, and kidney dysfunction and memory impairment.

b.            Arsenic

Arsenic is found to be the cause of a death of a woman in 2006. It was found out that she ordered from an online pharmacy based in Canada and studies show a big amount of arsenic poison in her medicine.

c.             Uranium

Uranium is one of the most deadly heavy metal which is also used in nuclear bombs. Small doses can cause kidney dysfunction and urinary tract damage.

2.            Actual Poison

a.            Rat Poison

On the term itself, intake of these substances are already hazardous to your health. In one study of hundreds of Viagra counterfeit medicines in Jakarta, Indonesia in 2012, FDA has found large amounts of rat poison on all drugs. Even in doses as low as 1gram it can still cause diarrhea, vomiting, hair loss and even death.

b.            Antifreeze

Antifreeze was once substituted for glycerin killing 365 people in Panama, 88 children in Haiti and harming many more. Lethal doses as small as 1/3 of a teaspoon can cause liver and kidney failure.

3.            Household Items

a.            Wall Paint

This substance is mostly used by counterfeiters to add color to the drugs. Paint pigments may contain different kinds of heavy metals which can cause blurred vision, nausea, vomiting and diarrhea.

b.            Floor wax

Floor wax is used to provide a nice sheen to mimic a medicine’s coating. This material contains formaldehyde which can cause vomiting, diarrhea and in extreme cases, death.

c.             Brick Dust

This is used by fraudsters to create a similar texture to real medicines. Brick dust contains poisonous heavy metals and chemicals.

The Dangerous Business of Drug Smuggling

Illegal trade of medicines considered harmful to health without proper monitoring and prescription is an international issue and a long-time problem among many governmental institutions.

There are rampant reports on the trade of drugs such as cocaine and heroin. It has long been a frustrating feature and the government as well as the public has been in constant pursuit against its distribution. After years of attempt to combat the illegal drug trade, nations have realized cooperation among international actions is the only effective way to restrain the trade.

Africa and Asia have been victims of these trades because of loose security. Because of the worsening effect on each nation, many cities have taken extra precaution on the deals involving drugs and medications.

Indonesia is one example of one of the nation’s known to have the most secured policy when it comes to punishing fraudsters in this field. From Jakarta to other parts of the archipelago, capital punishment is the worst penalty sentenced to those found guilty of smuggling illegal drugs within any part of the country. Earlier this year, nine foreign and local individuals were executed through firing squad because of drug trafficking.

However, war on drugs not only involves the illegal importation of medicine.

Counterfeited medicines which are legally distributed in the market and prescribed by legitimate doctors but are made with fake materials can also harm many individuals. The number of circulating within and without the country is vague. Since there are little tools we can use to determine the legitimacy of these drugs, the percentage of getting it smuggled into a country is high.

According to The Peterson Group, a non-profit organization which advocates the elimination of any use, production and distribution of counterfeit medicines, many scammers are continuously trafficking counterfeited medicines in countries with little or no anti-counterfeiting equipment.

Since the scope of drug trafficking varies from one country to another, many nations are forced to face the issue individually despite international cooperation.

Many people think that the issue of drug smuggling will take a long time to defeat. Some even think that it can never be solved at all. What many people do not understand is that drug smuggling and any business related herewith is dangerous.

Let this be a warning: drugs destroy lives and communities, undermine sustainable human development and generate crime. Drugs affect all sectors of society in all countries; in particular, drug abuse affects the freedom and development of young people, the world’s most valuable asset. Drugs are a grave threat to the health and well-being of all mankind, the independence of States, democracy, the stability of nations, the structure of all societies, and the dignity and hope of millions of people and their families.